MEDICARE: MAS TELEHEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1588439269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAS TELEHEALTH SERVICES

Provider Business Mailing Address
First Line	:	5165 COLUMBO CT
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6659
Country	:	US
Telephone Number	:	754-208-9967
Fax Number	:

Provider Business Practice Location Address
First Line	:	5165 COLUMBO CT
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6659
Country	:	US
Telephone Number	:	754-208-9967
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	ELENA BELOVA
Credential	:
Telephone Number	:	754-208-9967

Provider Enumeration Date	:	11/22/2023
Last Update Date	:	11/22/2023

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